Risk factors for hamstring muscle injury in male elite football: medical expert experience and conclusions from 15 European Champions League clubs

Abstract

ObjectivesTo describe the perceived importance of suggested hamstring injury risk factors according to chief medical officers (CMOs) of European male professional football clubs. A secondary objective was to compare if these perceptions differed between teams with a lower-than-average hamstring injury burden and teams with a higher than average hamstring injury burden.MethodsFirst, CMOs of 15 European professional male football clubs were asked to suggest risk factors for hamstring injury in their club. The perceived importance of the suggested risk factors was then rated by all participants on a 5-graded Likert scale. Participating teams were divided in two groups depending on their hamstring injury burden during the 2019/2020 and 2020/2021 seasons. The LOW group consisted of seven teams that had a lower than average hamstring injury burden. The HIGH group consisted of eight teams that had a higher-than-average hamstring injury burden.ResultsTwenty-one risk factors were suggested. The majority were extrinsic in nature, associated with coaching staff, team or club rather than players themselves. ‘Lack of communication between medical staff and coaching staff’ had the highest average importance (weighted average=3.7) followed by ‘Lack of regular exposure to high-speed football during training sessions’ (weighted average=3.6). The HIGH group perceived the player factors fatigue and wellness as more important than the LOW group.ConclusionAccording to CMOs recruited in this study, most risk factors for hamstring injuries are extrinsic and associated with the club and coaching staff, and not the players themselves.

A musculoskeletal multifactorial individualised programme for hamstring muscle injury risk reduction in professional football: results of a prospective cohort study

“…One reason could be a lack of buy-in from the assistant coach and head coach, with maximal velocity exposure mentioned as the most difficult training category to include systematically. This corresponds to the extrinsic risk factors reported in a recent HMI risk survey study among high-level European clubs 3. Furthermore, the physical coaching staff could have difficulties implementing the programme on double match weeks, irrespective of the reduction in target volume.…”

“…Despite this, the occurrence of HMI remains a problem 1. It is relatively agreed on that this could be partly due to the lack of multifactorial approaches and issues with compliance 3–6…”

Most modifiable risk factors for hamstring muscle injury in women’s elite football are extrinsic and associated with the club, the team, and the coaching staff and not the players themselves: the UEFA Women’s Elite Club Injury Study

“…There is an association between overall injury rates (not specifically hamstrings injuries) and the quality of internal communication at the club [ 10 ]. A previous study has highlighted the responsibility of the club and coaching staff in reducing the risk of hamstring injury specifically, in men’s professional football [ 13 ].…”

Muskelverletzungen im Sport

“…Nicht vermeidbare Risikofaktoren von Muskelverletzungen sind [6][7][8]: ▪ vorherige Verletzung ipsilateral (dieser Punkt ist der größte Risikofaktor! ), ▪ Alter (v. a. relevant bei der Wadenmuskulatur), ▪ Geschlecht (Verletzungen der ischiokruralen Muskulatur scheinen bei männlichen Sportlern häufiger vorzukommen als bei weiblichen).…”

“…Vermeidbare Risikofaktoren von Muskelverletzungen sind u. a. [6][7][8]: ▪ hohe Trainings-und Spielbelastung, ▪ muskuläre und/oder zentrale Ermüdung, ▪ unzureichendes Aufwärmen, ▪ reduzierte muskuläre Flexibilität, muskuläre Verkürzung, ▪ muskuläre Dysbalance, ▪ unzureichende Rumpfstabilität, ▪ Beckenkippung nach anterior, ▪ lumbale Pathologien, ▪ mangelnde Kommunikation zwischen medizinischer Abteilung und Trainer, ▪ unzureichendes/unregelmäßiges Sprinttraining.…”